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Four-drug regimen feasible in colorectal cancer

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A potent four-drug combination chemotherapy is possible in patients with metastatic or locally advanced colorectal cancer, but toxicity limits dosing, researchers report in the October 15th issue of the Journal of Clinical Oncology.

Dr. Matthew P. Goetz and colleagues at the Mayo Clinic, Rochester, Minnesota sought to determine the clinical effect and maximum tolerated doses of a combination of irinotecan (CPT-11), fluorouracil (FU), leucovorin (LV) and oxaliplatin in such patients.”This study,” he told Reuters Health, “builds upon the fact that these 4 drugs… are the most active chemotherapy drugs in colorectal cancer.”A total of 13 patients received intravenous CPT-11 infusion and bolus doses of FU/LV on days 1, 8, 15 and 22 and oxaliplatin infusion on days 1 and 15 every 6 weeks for a total of 37 courses.A further 22 patients were given a CPT-11 and oxaliplatin infusion on day 1 and a 90-minute bolus infusion of FU/LV on days 2 to 5 every 3 weeks for a total 122 courses.Dose-limiting toxicity in both cohorts required dose reduction. In the first cohort, these side effects included diarrhea and neutropenia. Additional side effects in the second cohort included vomiting and paresthesias.Antitumor activity was seen in both cohorts, and the researchers note that the toxicities “are significant, but manageable.””We demonstrated the feasibility of combining all 4 drugs, in two different schedules,” Dr. Goetz continued.”However,” he added, “significant dose reductions were required, and it is unclear whether the lower doses required when these 4 drugs are combined will result in effective therapy that bears comparison to current standard regimens.”(Source: J Clin Oncol 2003;21:3761-3769: Reuters Health: David Douglas: November 19, 2003: Oncolink)


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Dates

Posted On: 20 November, 2003
Modified On: 3 December, 2013

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